The present invention relates to an implant made of compacted microparticles and a method of manufacturing the compacted microparticles. The invention also relates to a method of administering such compacted microparticles to a subject.
In the administration of drugs and in the diagnosis of disease it is desirable, if not necessary, to effect a controlled release of one or more substances within the living organism, in particular within a mammal, over an extended period of time.
Controlled release over an extended period of time, however, is not possible by conventional methods of administering drugs such as oral administration or direct injection of a drug. Rather than providing a controlled concentration of the drug over an extended period of time, these methods of administration lead to an immediate release of the drug into the body followed by a decline in the blood level of the drug over time. The immediate release of drug, followed by a decline in the blood level of the drug over time, is often not the most desirable method of administration. Treatment of a disease or condition is often more effective when the level of the drug in the blood can be maintained at a desired constant level for an extended period of time. Moreover, the immediate entry of a drug into a body may create a concentration of the drug beyond the capacity of the active centers to accept the drug and may also exceed the capacity of the metabolic and excretory mechanisms of the living organism. If the level of the drug remains elevated, tissues and/or organs may suffer detrimental effects.
Continuous controlled release of a drug over an extended period of time has significant clinical advantages as well. For example, when drug treatment must continue for an extended period of time, oral administration or direct injection requires the inconvenience of repeated administration. Furthermore, when the treatment requires repeat administration there is the possibility that the patient will forget or purposely not administer the drug. If a drug can be administered in a continuous, controlled release manner over an extended period of time the need for repeat administration is avoided.
To achieve a desired blood level of a drug over an extended period of time a variety of implants have been developed that, when administered to a patient, provide continuous, controlled release, long term delivery of a drug. These formulations include dosage forms intended for ingestion, injection, vaginal and uterine insertion, percutaneous application, and subcutaneous implants, for example.
The implants contain the active agent or drug in combination with a polymeric delivery system that controls release of the drug. The drug is physically entrapped in the polymer matrix and is released from the matrix by diffusion through the polymer or breakdown of the polymer matrix. Typically, the polymeric delivery system is a biocompatible, biodegradable polymer matrix. The polymer matrix is, however, not always biodegradable. When non-biodegradable implants are used surgical removal of the implant is necessary after the drug has been released.
A number of matrix materials gave been developed for controlled release of drugs including polymer matrix materials made of hydrogels, gelatin, cellulose, organopolysiloxane rubbers, polyurethanes, waxes, polyvinyl alcohol, poly glycolic acid, and polylactic acid, for example. Frequently the polymer matrix is a copolymer of lactic acid and glycolic acid (xe2x80x9cPLGAxe2x80x9d, polylactic glycolic acid). Drug is released from the PLGA matrix by the hydrolytic breakdown of the matrix. As the polymeric matrix breaks down the drug is released into the surrounding body fluids.
The rate of drug delivery is affected by a variety of variables including, for example, the choice of the polymer matrix, concentration of the drug in the matrix, size and shape of the implant, method of manufacturing the implant, surface area of the implant, and pore size.
Microparticles are an example of a sustained release formulation, wherein the drug is administered in connection with a polymeric delivery system. Microparticles are fine particles of drug physically entrapped in the polymer matrix. The microparticles can be prepared by a variety of methods such as the phase separation method, described in European Patent No. 52,510, or by preparing a water-in-oil emulsion as described in U.S. Pat. No. 4,652,441 to Okada et al. Typically, the particle size is in the range of 0.5 to 400 xcexcm. The microparticles may be included in injections, oral preparations (powders, granules, capsules, tablets, etc.), nasal preparations, suppositories (e.g., rectal, vaginal) and so on. The drug is released in a controlled manner by degradation of the polymer matrix.
Microparticles are most commonly administered by injection. An injectable preparation of the microparticles is prepared by suspending the microparticles in a suitable fluid. Suspending microparticles in a suitable fluid, however, is problematic in that the microparticles often tends to flocculate or clump together. Thus, preparing the injectable suspension must be done properly and carefully and can be a very tedious process. In addition, material is often lost when the suspension of microparticles is drawn into the syringe. Yet another disadvantage of administering microparticles by injection is that the administration is associated with a xe2x80x9cburstxe2x80x9d or an immediate release of the drug over a short period of time, followed by a slower more uniform release. The burst precludes high core loading of the microparticles (the concentration of the active principal within the microparticles) because the burst increases with core loading. Therefore, in order to inject a certain amount of drug, one must inject a high quantity of material having a low core loading and, thus, a large volume of suspension fluid.
Subcutaneous implants are another example of a sustained release formulation, wherein the drug is administered in connection with a polymeric delivery system. Subcutaneous implants are solid bodies containing drug physically entrapped in a polymer matrix. The solid body is much larger than microparticles and is implanted under the patients skin either surgically or by sub-dermal injection using conventional implanting devices. The implants may have a variety of shapes including a film, rod, fiber, hollow cylinder, closed tube, and the like.
The subcutaneous implants are manufactured by first forming a mixture of the drug and polymer matrix and then forming the implant, of desired structural shape, by injection molding, compression molding, or extruding the resulting mixture to produce a solid, uniform, monolithic implant. The mixture of drug and polymer matrix is formed either by mixing the drug with the dry polymeric material in powdered form or by forming a solution or slurry of the drug and polymer and removing the solvent.
Subcutaneous implants, however, often do not provide continuous, uniform release of the drug and may exhibit a xe2x80x9cburstxe2x80x9d or a xe2x80x9cdead phasexe2x80x9d following administration. The xe2x80x9cdead phasexe2x80x9d is a period during which essentially no active ingredient is released.
Yet another implant device for continuous release of actives are osmotic mini-pumps. Osmotic mini-pumps are, however, expensive and require surgical implantation and removal.
The prior art discloses a number of delayed release polymer/drug formulations, including the following:
U.S. Pat. No. 3,887,699 to Yolles discloses an article for dispensing drugs prepared by dispersing a drug in a biodegradable polymeric material that can be formed into a solid shape. Drug is released when the drug migrates or exudes from the interior to the surface of the polymeric article and/or when the polymer degrades.
U.S. Pat. No. 4,351,337 to Sidman discloses a biocompatible, biodegradable implant device formed as a structure in which a drug or other releaseable substance to be delivered is physically contained by a poly-xcex1-amino acid.
U.S. Pat. No. 4,761,289 to Shalati et al. describes a method for preparing a sustained release pellet for use as an implant. The pellet, containing a water insoluble polymer and a water diffusible solid, is prepared by forming a mixture comprising a dispersion of a water diffusible solid in a solution of a non-aqueous solvent and a water insoluble polymer, removing the non-aqueous solvent from the mixture to substantially dry the mixture, comminuting the substantially dry mixture to form substantially dry particles, and forming a plurality of the substantially dry particles under pressure into a pellet. The process provides a homogenous implant. Diffusion of the diffusible solvent as body fluids gradually penetrate the pellet.
U.S. Pat. No. 5,023,082 to Friedman et al. discloses a sustained release composition that is suitable for implantation in the periodontal crevice for the treatment of periodontal disease.
U.S. Pat. No. 5,342,622 to Williams et al. discloses subdermally administered pharmaceutical veterinary implants for continuous release of a peptide or protein. The implant includes a peptide or protein and an excipient encased within a polymeric coating which is permeable, swellable, and, at normal physiological pH, is non-rupturing, non-dissolving, and does not degrade over the useful life of the implant.
U.S. Pat. No. 5,470,311 to Setterstrom et al. discloses an apparatus for dispensing micro encapsulated medicinal compositions. The apparatus generates a nebulizing gas stream that sprays or propels powdered microspheres, contained in a vial, into or onto an area to be treated as a stream.
U.S. Pat. No. 5,486,362 to Kitchell et al. discloses a method for treating individuals for drug dependence and a drug delivery system useful for treating drug dependence. The method comprises administering a therapeutic level of a drug substitute in a controlled, sustained release manner over a period of time having a duration of at least one day. The drug delivery system uses a physical constraint modulation system (xe2x80x9cPCMSxe2x80x9d) to contain the drug substitute. The PCMS may be a biodegradable polymer. The formulation of the biodegradable polymer and drug substitute may be suitable for subcutaneous or intramuscular injection and includes microparticles, microcapsules, and elongated rods of the polymer/drug substitute.
U.S. Pat. Nos. 4,652,441; 4,917,893; 5,476,663; and 5,631,021 to Okada et al. describe a prolonged release microcapsule and a process for producing the microcapsule.
U.S. Pat. Nos. 4,728,721 and 4,849,228 to Yamamoto et al. describe a biodegradable high molecular weight polymer useful as an excipient in producing pharmaceutical preparations, a method of producing the polymer, and microcapsules produced from the polymer.
U.S. Pat. Nos. 4,954,298 and 5,330,767 to Yamamoto et al. describe a sustained-release microcapsule for injection containing a water-soluble drug and a method for producing the microcapsules.
U.S. Pat. Nos. 5,480,656 and 5,643,607 to Okada et al. describe a microcapsule designed for zero order release of a physiologically active peptide over a period of at least two months.
U.S. Pat. No. 5,744,163 to Kim et al. describes a sustained released formulation of an animal growth hormone and a process for manufacturing the formulation. The process involves forming a mixture of hormone and excipient into a tablet using conventional tabletting methods and then coating the tablet with a polymer film.
U.S. Pat. Nos. 5,575,987 and 5,716,640 to Kamei et al. describe sustained-release microcapsules containing a biologically active substance adapted to release the biologically active substance at a constant rate over a protracted time starting immediately following administration without an initial burst and a method of producing the sustained-release microcapsules.
J. D. Meyer et al. in an article entitled xe2x80x9cPreparation and In Vitro Characterization of Gentamycin-Impregnated Biodegradable Beads Suitable for Treatment of Osteomyelitisxe2x80x9d in the Journal of Pharmaceutical Sciences, vol. 67, no. 9, September, 1998 describe implantable beads containing 6.7 percent gentamycin that are strung on a surgical suture and implanted in a wound following surgery. The beads are formed by compressing dry microparticles having a diameter of approximately 1 xcexcm. The microparticles are formed by a process that involves first solubilizing the drug molecule in an appropriate solvent using a process called hydrophobic ion pairing (HIP) and then forming the microspheres using a method termed precipitation with a compressed antisolvent (PCA). The beads exhibit drug release that is consistent with a matrix controlled diffusion.
A. Kader et al. In an article entitled xe2x80x9cFormulation Factors Affecting Drug Release from Poly(Lactic)Acid (PLA) Microcapsule Tabletsxe2x80x9d in Drug Development and Industrial Pharmacy, 25(2), 141-151, 1999 describe tablets of compacted microparticles for oral ingestion and oral drug delivery. Compaction results in tablets that are intact tablets or in tablets that disintegrate in the gastrointestinal tract. The disintegration of the tablets is influenced by compression pressure and added excipients.
There remains a need, however, for improved implants and improved methods for administering drugs and other substances in a continuous, controlled manner over an extended period of time. The present invention provides such an implant and methods.
The present invention relates to a pharmaceutical implant for controllably releasing a drug in a subject. The pharmaceutical implant includes microparticles of one or more drugs dispersed in a biodegradable polymer, wherein the microparticles are sufficiently associated to maintain a predetermined shape of the implant without complete fusing of the polymer and wherein the implant disintegrates into individual microparticles over time after administration.
The amount of the drug can be between about 0.5 to 95 percent (w/w) of the microparticles. Preferably, the amount of the drug is between about 5 to 75 percent (w/w) of the microparticles.
The biodegradable polymer can be a polymer of lactic acid, glycolic acid, polyethylene glycol, poly(ortho esters), poly caprolacatones, or copolymers thereof.
The pharmaceutical implant may further include one or more additives. The additives may be biodegradable polymers, mannitol, dextrose, inositol, sorbitol, glucose, lactose, sucrose, sodium chloride, calcium chloride, amino acids, magnesium chloride, citric acid, acetic acid, malic acid, phosphoric acid, glucuronic acid, gluconic acid, polysorbate, sodium acetate, sodium citrate, sodium phosphate, zinc stearate, aluminum stearate, magnesium stearate, sodium carbonate, sodium bicarbonate, sodium hydroxide, polyvinylpyrrolidones, polyethylene glycols, carboxymethyl celluloses, methyl celluloses, starch, or a mixture thereof.
The pharmaceutical implant can have a cylindrical shape with a diameter between about 0.5 to 5 mm, and a length of between about 0.5 to 10 cm. Preferably, the diameter is between about 1 to 3 mm and a length of between about 1 to 5 cm.
The invention also relates to a method for controllably releasing a drug in a subject by administering to the subject a pharmaceutical implant including microparticles of one or more drugs dispersed in a biodegradable polymer, wherein the microparticles are sufficiently associated to maintain a predetermined shape of the implant without complete fusing of the polymer and wherein the implant disintegrates into individual microparticles over time after administration. The implant can be administered intramuscularly or subcutaneously and may be administered surgically or by using an implantation device. The implantation device may be pre-filled with the implant.
The invention further relates to methods of preparing a pharmaceutical implant for controllably releasing a drug in a subject. One embodiment of the method involves the steps of: placing microparticles of one or more drugs dispersed in a biodegradable polymer in a forming zone defined by a vessel having an upper end and a lower end, wherein the upper end has an opening to permit the microparticles and a fluid to be introduced into the forming zone, the lower end is covered with a seal that prevents the microparticles from exiting the forming zone but allows gases and fluids to exit the forming zone; adding a fluid to the upper end of the forming zone in an amount sufficient to evenly coat the microparticles to increase adhesion of the microparticles; applying a pressure to the upper end of the forming zone to compact the microparticles and sufficiently associate the microparticles so that they maintain the shape of the forming zone without complete fusing of the polymer; removing the compacted microparticles from the forming zone in the shape of the implant; and drying the compacted microparticles to provide a pharmaceutical implant that disintegrates into individual microparticles over time after the implant is administered to a subject.
The method may also include adapting the lower end of the forming zone to receive a vacuum and applying a vacuum to the lower end of the forming zone, after the fluid is added, to evenly coat the microparticles with the fluid. The vacuum may create a reduced pressure of between about 2 and 50 inches of mercury.
A second embodiment of the method involves the steps of: combining microparticles of one or more drugs dispersed in a biodegradable polymer with a fluid to form a wet granulate; placing the wet granulate in a forming zone defined by a vessel having an upper end and a lower end, wherein the upper end permits the wet granulate to be introduced into the forming zone and the lower end prevents the microparticles from exiting the forming zone; applying pressure to the upper end of the forming zone to compact the microparticles and sufficiently associate the microparticles so that they maintain the shape of the forming zone without complete fusing of the polymer; removing the compacted microparticles from the forming zone in the shape of the implant; and drying the compacted microparticles to provide a pharmaceutical implant that disintegrates into individual microparticles over time after the implant is administered to a subject.
The applied pressure is from about 1 kg/cm2 and 1,000 kg/cm2. The pressure is applied for between about 1 second to 10 minutes. The upper end of the forming zone may be adapted to receive a plunger and the pressure applied using the plunger.
The microparticles may be combined with one or more additives to form a mixture before placing the mixture in the forming zone. Similarly the wet granulate may be combined with one or more additives before placing the wet granulate in the forming zone. The additives can be biodegradable polymers, mannitol, dextrose, inositol, sorbitol, glucose, lactose, sucrose, sodium chloride, calcium chloride, amino acids, magnesium chloride, citric acid, acetic acid, malic acid, phosphoric acid, glucoronic acid, gluconic acid, polysorbate, sodium acetate, sodium citrate, sodium phosphate, zinc stearate, aluminum stearate, magnesium stearate, monobasic sodium, sodium carbonate, sodium bicarbonate, sodium hydroxide, polyvinylpyrrolidones, polyethylene glycols, carboxymethyl celluloses, methyl celluloses, starch, or a mixture thereof. The additive, when present, is present in an amount of between about 0.05 percent (w/w) and 75 percent (w/w) of the implant.
The fluid is added in an amount of between about 20 percent (v/w) and 200 percent (v/w) of the weight of the microparticles. The fluid can be one or more of water, ethanol, methanol, or heptane. A solute may also be added to the one or more fluids. The solute may be mannitol, a salt, polyethylene glycol, an acid, a base, or a mixture thereof.
The compacted microparticles may be dried at a temperature of between about 15xc2x0 C. to 40xc2x0 C. The compacted microparticles may be dried under reduced pressure or in the presence of a desiccant.